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Systems fit for the future: How to support an ageing population

The ageing population is often described as a burden, or even a tidal wave of need, which is relevant to systems innovation because this perspective is driven by a fear of system collapse. The systems in question - such as pensions and care - are creaking to the point of failure and are major causes for concern.

This means the widespread negativity towards older people is actually a symptom of system failure and that systems innovation provides a way out by creating ways of living and working fit for the future, not the past. The demographic shifts are too strong for us to muddle along with existing, out of date systems.

The problem with many existing systems is that they were designed for different demographic conditions - both fewer older people and older people living shorter lives. And the mismatch between these systems and demographic reality means that the great success story of the twentieth century - humans living significantly longer - is being treated as a problem. This bizarre situation is testament to the power of systems, both as enablers when they work well and disablers when they're out of synch. 

We've recently published a report Five Hours a Day: systemic innovation for an ageing society, which argues that we are part way through systemic change on ageing. Some progress has been but there is much further to go before we will have successfully adapted to an ageing society. The report also makes the case for social innovation because while scientific and technological innovation continues apace, innovation in our social institutions is lagging far behind. 

This misalignment is felt keenly in the labour market and healthcare systems which are both founded on different demographic assumptions. Our employment market has developed on the assumption that we might expect just a handful of healthy years after sixty. And our healthcare system is designed for the effective management of acute and infectious disease.

But our ageing society means that the big challenges are different now - how to enable people to remain purposeful for several decades in the second half of life and how to live well with multiple long term health conditions. Both employment and health systems are struggling to adapt to the new demographic reality. 

So, what can be done? Well, it isn't easy but it is important. We'll soon be publishing our work on People Powered Health which sets out the changes needed in our health system to meet the long term conditions challenge. And in Five Hours a Day we make the simple point that systems change needs different types of change at once - in terms of market innovation, political innovation, cultural innovation and product innovation.

It's surprising how often the multi-dimensional nature of change is lost as we all search for the single 'silver bullet' that will solve the issue. We know, however, that systems change requires cultural shifts as well as new business models, new policies and new services. It takes time, leadership from multiple sources, commitment to realise the vision and perseverance to succeed. The prospect of change seems overwhelming but we should remember that systems are created, not fixed, and that we have the power to change them.   

Halima Khan is a Director in the Public Services Lab at Nesta

"Five hours a day: systemic innovation for an ageing population" has been published along with the living map of ageing innovations at www.ageinginnovators.org

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Halima Khan

Halima Khan

Halima Khan

Executive Director, Health Lab

Halima is Executive Director of the Health Lab, which aims to create a people powered health system. Health Lab brings together Nesta's practical work on health and ageing to achieve...

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